Individuals who are stable ART clients are assessed by a nurse at the facility and enrolled in the six-monthly appointment programme (SMA). These clients are no longer required to see the clinician at each health care visit. The client goes directly to the SMA room in the facility run by health surveillance assistants (paid community health workers) to collect a 3-month ART refill from their repeat script. Clients are required to see the clinician twice a year for clinical review including re-scripting. Clients have their viral load taken once every two years at the facility using point of care viral load on the date of their clinical review. The result is assessed by the clinician as part of the clinical review.